Affiliations: NDT Pediatric Therapy, Rockingham, NC, USA | Division of Physical Therapy, University of North
Carolina-Chapel Hill, Chapel Hill, NC, USA | Functional Outcome Specialist, Genzyme Corporation,
Chapel Hill, NC, USA
Abstract: Modified Constraint Induced Movement Therapy (CIMT) and
Neuro-Developmental Treatment (NDT) are both intervention strategies that focus
on active practice to optimize function. CIMT involves constraint of the less
involved upper extremity during function and NDT includes facilitation of
optimal postural control and symmetry to enhance the ability to complete a
given motor function. The purpose of this article is to describe an
intervention protocol for children with hemiplegia that integrates key NDT and
CIMT principles. Two children participated in a modified CIMT (mCIMT)/NDT
program 2 hours a day for two months. The children wore a constraint on the
less involved arm and participated in guided play with early intervention
members and parents. Play was individualized to developmental level and
incorporated principles of NDT. Function was measured pre- and
post-intervention using the PDMS-2, QUEST, ACQUIRE Therapy Motor Patterns, and
ACQUIRE Functional Activities. Both children demonstrated motor skill
acquisition, improved quality of functional use, and increased frequency of
bilateral hand use. Parents found the protocol challenging but manageable in
their daily routines. The inclusion of NDT principles within a mCIMT protocol
may be an effective intervention to maximize functional motor skill acquisition
in children with hemiplegia. Additional research is warranted to support this
intervention.
Keywords: Cerebral palsy, hemiplegia, Constraint Induced Movement Therapy, Modified Constraint Induced Movement Therapy, Neuro-Developmental Treatment, infant toddler program, early intervention services
